Glybomet

Glibomet is a combination drug containing two active ingredients: glibenclamide and metformin hydrochloride. Glibeneclamide belongs to the sulfonylurea class and helps lower blood sugar levels by stimulating the release of insulin from the pancreas. Metformin hydrochloride belongs to the biguanide class and reduces glucose production in the liver, increases tissue sensitivity to insulin and improves glucose absorption. Glibomet is used to treat type 2 diabetes, especially in patients who are not effectively treated with glibenclamide or metformin monotherapy.

Indications Glybometa

Glibomet (glibenclamide, metformin hydrochloride) is used to treat type 2 diabetes mellitus in adults. Indications for its use include cases where diet, exercise, and lifestyle changes are not effective enough to control blood sugar levels. This combination drug may also be recommended for patients who do not achieve target glycemic levels with glibenclamide or metformin monotherapy.

Release form

Glibomet is usually available as a tablet to take by mouth.

Pharmacodynamics

1. Glibenclamide:

   • Glibenclamide belongs to a class of drugs called sulfonylureas. It is an insulin secretagogue.
   • The mechanism of action of glibenclamide is that it increases the release of insulin from pancreatic β-cells by closing potassium channels in the beta-cells, which leads to membrane depolarization and subsequent calcium entry into the cell, causing insulin release.
   • Glibenclamide also increases tissue sensitivity to insulin.

2. Metformin hydrochloride:

   • Metformin is a drug from the biguanide class. Its mechanism of action is associated with a decrease in glucose production in the liver and an improvement in peripheral sensitivity to insulin.
   • It reduces the absorption of glucose from food in the intestine and increases the use of glucose by muscles.

3. Combined effect:

   • The combination of glibenclamide with metformin allows for more complete and balanced control of blood glucose levels in patients with type 2 diabetes mellitus.
   • The combination of these two drugs provides a reduction in blood glucose by stimulating insulin secretion and improving tissue sensitivity to insulin, as well as reducing the absorption of glucose from food and reducing glucose production in the liver.

Pharmacokinetics

1. Glibenclamide:

   • Absorption: Glibenclamide is usually rapidly and completely absorbed from the gastrointestinal tract after oral administration.
   • Metabolism: Glibenclamide is metabolized in the liver to form active metabolites. They also have a hypoglycemic effect.
   • Excretion: Glibenclamide and its metabolites are excreted mainly in the urine.
   • Duration of action: Glybenclamide lasts about 12-24 hours, so it is usually taken once or twice a day.

2. Metformin hydrochloride:

   • Absorption: Metformin hydrochloride is generally absorbed from the gastrointestinal tract slowly and incompletely.
   • Metabolism: Metformin is practically not metabolized in the body. It remains unchanged and is excreted in the urine.
   • Excretion: About 90% of metformin is excreted unchanged by the kidneys.
   • Duration of action: Metformin usually lasts about 12 hours and is often taken two or three times a day.

Dosing and administration

1. Directions for use:

   • Glibomet tablets are usually taken orally, i.e. through the mouth.
   • They are swallowed whole with a small amount of water.
   • The tablets should be taken during or immediately after meals.

2. Dosage:

   • The dosage of Glibomet is determined by the doctor and may vary depending on the individual needs of the patient and the characteristics of the disease.
   • The usual starting dose for adults is one tablet containing a combination of glibenclamide and metformin, taken once or twice daily.
   • The dosage may be changed as recommended by the doctor depending on the patient's blood glucose level.

3. Duration of admission:

   • The duration of taking Glibomet is usually determined by the doctor depending on the nature and severity of diabetes.
   • The drug is usually taken over a long period of time to control blood glucose levels.

Use Glybometa during pregnancy

Using the combination of glibenclamide and metformin (Glibomet) during pregnancy is associated with a number of potential risks and requires careful medical supervision. Here are some key points based on research:

1. Metformin: Considered relatively safe for use during pregnancy and may be used as an alternative to insulin for the treatment of gestational diabetes mellitus (GDM). Metformin does not cause birth defects and may reduce the risk of miscarriage, preeclampsia, and subsequent development of gestational diabetes. However, approximately 46% of women taking metformin may require the addition of insulin to achieve glucose control (Holt & Lambert, 2014).
2. Glibenclamide: Effectively lowers blood glucose in women with gestational diabetes, possibly with a lower rate of treatment failure compared with metformin. However, its use may be associated with an increased risk of preeclampsia, neonatal jaundice, prolonged neonatal intensive care unit stay, macrosomia, and neonatal hypoglycemia (Holt & Lambert, 2014).

It should be noted that the long-term effects of using oral hypoglycemic agents in the womb have not been fully studied, and additional studies are needed to assess their safety and effectiveness. The use of Glibomet during pregnancy should only be carried out after careful discussion with the attending physician, who can assess all potential risks and benefits.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to glibenclamide, metformin or any of the ingredients of the drug should not take Glibomet.
2. Diabetes mellitus type 1: Glibomet is not recommended for the treatment of diabetes mellitus type 1, which is characterized by absolute insulin deficiency.
3. Hypoglycemic agents: The use of glibenclamide may be contraindicated in patients taking certain hypoglycemic agents or insulin, particularly if this may lead to hypoglycemia.
4. Liver failure: In patients with severe liver failure, Glibomet should be used with caution and under medical supervision, since changes in drug metabolism may require dosage adjustment.
5. Pregnancy and breastfeeding: There is limited data on the safety of glibenclamide and metformin during pregnancy and breastfeeding, so their use during this period should only be carried out on the advice of a doctor.
6. Paediatric population: The efficacy and safety of Glibomet in children have not been established, so its use in children may require consultation with a physician.
7. Elderly: Elderly patients may require more careful administration and regular monitoring when using Glibomet.

Side effects Glybometa

1. Hypoglycemia (low blood sugar), especially if the drug is taken incorrectly or taken with other antidiabetic drugs.
2. Gastrointestinal disorders such as nausea, vomiting, diarrhea, constipation.
3. Uretic dysfunction (problems with urination).
4. Metallic taste in the mouth.
5. Increased levels of lactic acid in the blood (lactic acidosis), especially in patients with impaired kidney function.
6. Increased levels of urea and creatinine in the blood.
7. Allergic reactions such as skin rash, itching, hives.
8. Increased sensitivity to sunlight (photosensitivity).

Overdose

1. Hypoglycemia: This is the most serious and common side effect of overdosing on sulfonylureas, including glibenclamide. Symptoms may include hunger, tremors, loss of consciousness, irregular heartbeat, nervousness, and even seizures.
2. Acid-dependent metabolic acidosis: This is a potentially dangerous complication of metformin overdose. Symptoms include profound and rapid respiratory failure, drowsiness, weakness, abdominal pain, and vomiting.
3. Other side effects: May include headache, dizziness, nausea, vomiting, diarrhea, and various disturbances in the functioning of the heart and central nervous system.

Interactions with other drugs

1. Drugs that increase hypoglycemic effect:

   • Medicines that lower blood glucose levels (eg, insulin, other sulfonylurea derivatives) may enhance the hypoglycemic effect of glibenclamide. This may lead to the development of hypoglycemia (low blood sugar).
   • Medicines that also lower blood glucose levels, such as other antidiabetic drugs or drugs containing alpha-glucosidase, may also enhance the hypoglycemic effect of glibenclamide.

2. Drugs that increase the risk of lactic acidosis:

   • Drugs that may increase the risk of developing lactic acidosis, such as certain antibiotics (eg, macrolides), certain X-ray contrast agents, or alcohol, may increase the side effects of metformin such as metabolic acidosis.

3. Drugs that affect kidney function:

   • Because metformin is eliminated primarily through the kidneys, drugs that also affect kidney function (such as some nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics) may increase the risk of metformin building up in the body and increase its side effects.

4. Drugs that affect liver function:

   • Since glibenclamide is metabolized in the liver, drugs that affect liver function (eg, inhibitors or inducers of liver enzymes) may alter its pharmacokinetics.

5. Drugs affecting the digestive tract:

   • Some medications, such as anti-acids, may slow or decrease the absorption of metformin from the gastrointestinal tract.